In CMS
Nov 1st, 2018
Anthem paid a $16 million settlement resulting from a series of attacks in both 2014 and 2015 that had the potential to expose personal health information (PHI) of 79 million people.  Although they paid the $16 million settlement, Anthem does not admit to any wrong doing.  This represented the largest PHI breach in US history ...
In CMS
Sep 11th, 2018
The Centers for Medicare & Medicaid Services (CMS) knows there is a lot of administrative overhead when submitting medical claims for payment. To help you navigate through the red tape, CMS has created a “Administrative Simplification Basics Series,” where you can Sign up for Administrative Simplification email updates. The series helps the healthcare community use electronic ...
Jun 13th, 2018
A medical coder transforms healthcare diagnosis, procedures, medical services, and equipment into universal medical alphanumeric codes. Those codes are taken from medical record documentation, such as physician’s notes, laboratory and radiologic results, etc., to be paid by insurance carriers and government payers. Medical coders check the medical chart to ensure the codes are correct and ...
In Audit
May 30th, 2018
Retail giant accused of submitting claims for payment to Minnesota’s Medicaid program in violation of rules. Wal-Mart Stores, Inc. and Sam’s West, Inc. (d/b/a/ Sam’s Club) have agreed to pay a total of $825,000 to resolve False Claims violations, according to a May 29 press release from the U.S. Attorney’s Office for the District of Minnesota. ...
In Audit
May 2nd, 2018
Have you always wanted to see what an Office of Inspector General (OIG) investigational take down of a healthcare fraud scheme is like? Now is your chance. The U.S. Department of Health and Human Services’ (HHS) has a “This is Real” series of podcasts, which takes you undercover with OIG special agents as they work ...